American Indians/Alaska Natives have the highest rates of substance abuse compared to any other ethnic/racial group in the U.S. Despite the high rates of substance abuse in this population, there are significantly limited culturally tailored treatment approaches available for this population. Drum therapy is an indigenous treatment approach that has been utilized for many centuries to promote healing and self- expression. More recently, Drum Circles have been developed as a specific therapeutic approach used across the mental health care continuum. We propose to develop and pilot test Drum-Assisted Recovery Therapy for Native Americans (DARTNA), a treatment approach that encompasses Drum Circles and the 12-steps of Alcoholics Anonymous within the conceptual framework of the Native American Medicine Wheel. Los Angeles has the largest population of American Indians/Alaska Natives in the U.S. and has a well-established medical facility and substance abuse clinic providing an appropriate and feasible site for the proposed intervention. By developing and implementing DARTNA, the proposed study addresses an urgent need to develop and empirically test a culturally tailored substance abuse protocol for American Indians/Alaska Natives with substance abuse disorders. The proposed project has the following specific aims: 1) develop and pretest a culturally tailored treatment strategy (DARTNA) for American Indians/Alaska Natives with alcohol and drug use disorders and 2) conduct a pilot study to assess the effect of DARTNA. The program to be developed and the data collected in the proposed study will establish a basis for a future, larger trial on effectiveness of this treatment protocol. If proven effective, the treatment protocol can be widely applied throughout American Indian/Alaska Native communities throughout the U.S. PUBLIC HEALTH RELEVANCE: The study is important since the need for developing and analyzing culturally relevant substance abuse treatment approaches for American Indians/Alaska Natives is significant and has the potential to enhance treatment outcomes in this severely affected population. Providing American Indians/Alaska Natives with culturally relevant treatment strategies will assist towards enhancing treatment options and decreasing related consequences of substance abuse in this population including associated medical conditions and mental health problems such as suicide, homicide, trauma and abuse which occur at high rates in this population. The proposed study will develop and analyze a potentially effective intervention that helps to address this important public health problem in the American Indian/Alaska Native population.